Dr. B and the Women

10.12.2009

By T Cooper

It's almost summer, but it looks a little bit like Christmas at Dr. Marci Bowers's house. Who has time to take down a stray strand of silver tinsel when you're one of the busiest genital reassignment surgeons in the world, responsible for constructing more vaginas every year in this country than any other doctor? That can mean as many as two per day, three or four days a week, out of a tiny regional hospital in small-town Trinidad, Colo.: a virtual pussy factory smack in the middle of our heartland.

There's that old joke, not entirely undeserved, that doctors -- and surgeons in particular -- believe they do the work of God. But in the case of the 51-year-old Dr. Bowers, one might forgive such grandiosity. When she comes home after a long day in the operating room, Bowers, a willowy, blonde, bombshell-nerd hybrid, sometimes says to her partner of six years, 'Carol, I changed a man into a woman, a woman into a man, and the dog into a cat today. What did you do?'

Carol Cometto, 48, loves telling that story, which she does, twice to me and a couple more times to others, punctuating each retelling with a husky smoker's laugh. A barrel-chested, sun-flogged, old-school butch who used to work on the railroad and is missing a couple fingers from an unrelated accident, the dark- and curly-haired Cometto is immediately infinitely more accessible than her partner. Where Bowers is at first reserved and impenetrable, visibly sussing me out before deciding how much to offer, Cometto happily shares to the point where I start to wonder, Does Marci know she's telling me all this shit?

'I don't want to be like [Oprah's beau] Stedman,' Cometto insists, as she guzzles a Coke at the kitchen table of the Morning After, the home she maintains and operates in Trinidad as a recovery facility for Bowers's surgical patients. These days they're mostly male-to-female (MTF) transsexuals who have paid about $22,000 and patiently spent up to a year on the waiting list before making the trek to rural, off-the-grid Trinidad in order to take advantage of Bowers's considerable talents. (She does a small but growing number of female-to-male surgeries -- not phalloplasty, which is a still somewhat imperfect procedure Bowers doesn't care for, but a clitoral-release technique called a metoidioplasty -- but the vast majority of trans patients come to Bowers for her trademark one-stage MTF vaginoplasty.)

And let me tell you -- since we cannot show you in these pages -- the vaginas she builds look good. Bowers is a maestro with the scalpel. 'They didn't really design a woman's vulva with efficiency in mind -- or aesthetics for that matter,' she tells me, chuckling, when asked to compare Mother Nature's handiwork to her own. 'I get feedback all the time from natal women. They go, 'Wow, that looks better than mine. That's better than the real thing!''

Bowers should know -- because she's seen a hell of a lot of them, even if she doesn't have one of her own. Natal vaginas, that is. Because before she started performing gender reassignment surgeries, Bowers was a conventional OB/GYN, fielding standard-issue lady health concerns like pregnancies, deliveries, C-sections, hysterectomies, ovarian cysts, UTIs, family planning, and so on. Only back then, Dr. Marci Bowers was Dr. Mark Bowers, a married man with three children and a thriving medical career in Seattle.

'My friends ask me, 'Did Marci do hers?' And I say, 'Yeah, dumb fuck!' ' Cometto cracks herself up, pouring more Coke and waiting for the caramel head to fizzle before taking a monster sip. A basket of fake grapes, a polar bear coffee mug, and well-thumbed issues of Elle, Redbook, and Marie Claire sit on the kitchen table beside her. 'Of course Marci didn't do her own surgery.'

Not that Cometto has always been so blas' about 'changers,' the term she uses for transpeople. When she first met Bowers, Cometto nursed a major crush and started flirting right off the bat, but had no inkling that Bowers had not been born female. It was only when a good friend suggested as much that Cometto's suspicions were aroused. Bowers and Cometto occasionally played golf together, and it was during an afternoon on the links that Cometto admits to clumsily attempting to peer down Bowers's shirt every time she teed off -- to see if her breasts were real. (No verdict based on the boobs.) Later, that same friend's father, who was on the hospital board and thus knew what Bowers's practice involved, showed Cometto a video on the Internet in which Bowers comes out as trans. Cometto says, 'I was like, 'This is fucked up. I'm out.''

'It just took me a long time to be with Marci, because I was so scared. I'd never seen one,' Cometto adds sheepishly, referring to a surgically constructed vagina. Cometto, a lifer lesbian who drives around her native Trinidad in a dusty Jeep Cherokee with a huge vaginatarian sticker on the back, 'was like wha -- what the fuck do I do? Where's the switch on this bad boy?'

It's not something Bowers seems to like to talk about much. 'That's just ancient history,' she insists. 'I'm not a transgender person. I'm a woman, and I just have a regular life like anybody else.' Which is a little like Brad Pitt insisting he's 'just a dad.' But in the prodigious media coverage of her, much is made of Bowers's MTF status, which is frequently featured front and center. And she will, when pressed, admit that her personal life trajectory might help bring a little more empathy to her practice than that of earlier, non-trans practitioners of vaginoplasty. Most telling, it is her trans status that many of Bowers's patients claim is a deal sealer with regard to choosing a gender reassignment surgery (GRS) doctor. But it's clear the instant you meet Bowers that she is first and foremost a surgeon, one who takes her practice seriously and is not satisfied with resting on her laurels. She even drives like a surgeon, rolling through stop signs and cutting a precise, though deliberately circuitous, route through Trinidad's back roads in her red Infiniti sedan, almost as though she's being pursued. Only after surgeon on the Bowers hierarchy of identities is she a woman. Then, perhaps, parent, which is probably on par with being a partner to Cometto, followed by decent golfer, good cook, vegetarian, avid reader, and so on -- until maybe, finally, if you press her, a transgender person.

Bowers grows perturbed when I inquire about the differences between the surgery she had 11 years ago and those she performs now, whether it's difficult to be working her magic daily for others, when she cannot do the same for herself. 'It's unrelated, doesn't even cross my consciousness,' she says. 'Sure, if I had my druthers, I'd have the surgery I do now. Particularly from a visual standpoint. Functionally, they got it, though -- the second generation surgeons,' she says of doctors like Pierre Brassard and Toby Meltzer, who used to do the surgery in two stages, while Bowers famously does hers in one. 'The thing is, there was a lot more scarring than we see now, and it doesn't look as good. But I have a partner who's happy with me the way I am.'

'You know these documentaries?' Cometto asks me, referring to the video of a pre-op Marci. 'I'll leave. I don't want to know about that. I don't know that person, because that person I wouldn't have looked twice at, and that person wouldn't have given two cents about me. But Marci -- I'm in love with the soul of that person. So when I see the guy, it just really freaks me out.'

'It was months before we were ever really intimate,' Cometto adds, quieter now. 'I was just nervous. And it takes a lot longer for them to -- you know.'

But they do. Come, that is. In fact, more than 90% of Bowers's patients report being able to achieve orgasm postsurgery. Which keeps them coming and coming -- to Trinidad, for the form-plus-function that the good doctor is able to deliver (and has delivered more than 600 times, with only 20 patients returning for a second surgery to address minor complications or concerns). 'Sometimes surgeons reach a level of comfort where it's very difficult to make fundamental changes to a procedure. They can be done, but there's always that learning curve,' Bowers says. 'But I really did. It's 180 degrees different from what it was just five years ago.'

Note to the fellas who were born with penises and would like to keep them: You may want to cross your legs about now, because here's how Dr. Bowers lays down a vagina where a penis was merely hours before. First, the patient is asked to undergo multiple sessions of presurgery laser hair removal or electrolysis to clear follicles from the region (skin from both the penis and the scrotum will end up inside the neo-vagina, so for obvious reasons, you don't want hair growing there). Once in the operating room with the patient under general anesthesia, scrotal skin is harvested and the testicles are amputated and discarded with the rest of the hospital's biomedical waste. The urethra is catheterized and the penile shaft divided in two (think string cheese), with the erectile portions of it removed, again for obvious reasons. Then, retaining constant blood flow, the clitoris is created from the glans of the penis and a bit of skin from the shaft, and securely stitched into place.

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